Wire connector structures for tubular grafts

ABSTRACT

Connector structures are provided for attaching elongated flexible tubular grafts to the body organ tubing of a patient. The connector structures are formed from wire. A first set of connector wires may be disposed around the periphery of one end of an elongated flexible tubular graft. A second set can be disposed around the periphery of the elongated flexible tubular graft spaced sufficiently from the first set of connector wires to define a gap. The portion of body organ tubing to which the elongated flexible tubular graft is to be attached is received in the gap and engaged by the first and second sets of connector wires. The wires may be formed in the shape of loops. If desired, hooks may be provided on the ends of the wires. The wires may be curved to accommodate attachment of the graft to tubular body organ tubing. The wires may also be formed in annular shapes. The connector structures may be formed as stand-along ring-shaped connectors. Obliquely-angled connections between grafts and body organ tubing may be made using the connector structures.

BACKGROUND OF THE INVENTION

This invention relates to tubular graft structures for replacing orsupplementing a patient's natural body organ tubing. More particularly,the invention relates to structures for connecting the ends of suchtubular graft structures to body organ tubing.

A patient's weakened or diseased body organ tubing can often be repairedby replacing or supplementing the patient's existing natural body organtubing with an artificial graft structure. One suitable type ofartificial graft structure uses a tubular nitinol mesh frame coveredwith a silicone coating, as described in Goldsteen et al. U.S. patentapplication Ser. No. 08/745,618, filed Nov. 7, 1996. Such grafts arehighly flexible, so they recover their shape after being stretched.Accordingly, a graft of this type may be stretched axially to reduce itsradial dimension and then installed in a patient intraluminally (e.g.,through an existing vein or artery). Once delivered to the properlocation within the patient, the axially stretched graft may bereleased, whereupon it expands to regain its original shape.

In addition, flexible artificial grafts may be made distensible likenatural body organ tubing to help reduce clot formation when used invascular applications. Flexible artificial grafts may also be madebiocompatible by adjusting their porosity and the composition of theircoatings.

Various connector structures may be used to attach flexible artificialgrafts to a patient's body organ tubing. For example, a graft may besurgically attached to a patient's body organ tubing with sutures. Toinstall a graft intraluminally, a pronged ring may be expanded fromwithin the end of the graft, thereby piercing the graft and attaching itto surrounding body organ tubing. Barbed flaps and wire hooks may alsobe used to attach grafts to body organ tubing. Connector structures ofthese types and other suitable connector structures are described in theabove-mentioned Goldsteen et al. U.S. patent application Ser. No.08/745,618, filed Nov. 7, 1996 and in Bachinski et al. U.S. patentapplication Ser. No. 08/839,199, filed Apr. 23, 1997.

Although connector structures of these types have various usefulfeatures, it would be desirable if connector structures with otherfeatures were available.

It is therefore an object of the present invention to provide improvedconnector structures for attaching grafts to a patient's body organtubing.

SUMMARY OF THE INVENTION

This and other objects of the invention are accomplished in accordancewith the principles of the present invention by providing connectors forattaching flexible graft structures to body organ tubing. The connectorsmay be entirely or nearly entirely from wire. The flexibility of thewire allows the connectors to be radially contracted during intraluminalinsertion into a patient and subsequently radially expanded at theinstallation site. In addition, the flexibility of the structures makesit possible to match the compliance or flexibility characteristics ofthe connector with the compliance of the body organ tubing andartificial graft structures at the attachment site.

To form a secure connection between the graft and the body organ tubing,the wire for the connectors can be arranged in two opposing groups ofwires near the end of the graft. The wires in the first of the twogroups are arranged about he periphery of the end of the graft. Thewires in the second group are spaced by a gap from the wires in thefirst group along the longitudinal axis of the graft The body organtubing is held in the gap by the two opposing groups of wires.

The wires in the connectors may be loops or may be individual wires. Thewires may also be curved to accommodate connections between grafts andnatural body organ tubing that is tubular in shape.

If desired, the connectors may be used to form non-right-angleconnections between grafts and body organ tubing.

The connectors may also be annular in shape. Such annular connectors maybe formed by molding a heat-sensitive wire mesh over an appropriatemandrel and heat treating the wire.

Further features of the invention, its nature and various advantageswill be more apparent from the accompanying drawings and the followingdetailed description of the preferred embodiments.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a partially cut-away perspective view of an artificial graftstructure attached to two sections of body organ tubing withillustrative connectors in accordance with the present invention.

FIG. 2 is a partly-sectional side view of an illustrative graft havingwire connectors that are engaging a portion of body organ tubing inaccordance with the present invention.

FIG. 3 is a side view of an illustrative graft with wire connectors inaccordance with the present invention.

FIGS. 4a and 4b are side views of portions of illustrative grafts havingwire connectors that are interwoven and attached to the wire mesh of agraft in accordance with the present invention.

FIG. 5 is a side view of a portion of an illustrative graft having awire connector attached at points of the mesh other than the wireintersection points of the mesh in accordance with the presentinvention.

FIGS. 6a, 6b, 6c, and 6d are perspective views of illustrative hookstructures for use with the connectors of the present invention.

FIG. 7a is a perspective view of an illustrative flattened portion of awire connector in accordance with the present invention.

FIG. 7b is a perspective view of an illustrative flattened and hookedportion of a wire connector in accordance with the present invention.

FIG. 8 is a perspective view of an illustrative webbed wire connectorstructure in accordance with the present invention.

FIG. 9 is a side view of an illustrative graft with looped wireconnectors in accordance with the present invention.

FIGS. 10a, 10b, and 10c are side views of a graft with illustrativeconnector structures in accordance with the present invention in whichthe use of a sheath to attach the graft to a portion of body organtubing is shown.

FIG. 11 is an end sectional view of an illustrative connectorarrangement in accordance with the present invention in which theconnector wires are curved to accommodate the curvature of the tubularbody organ tubing to which the graft is connected.

FIG. 12 is a sectional view taken along the line 12--12 in FIG. 11.

FIG. 13 is an end sectional view of another illustrative connectorarrangement in accordance with the present invention in which theconnector wires are curved to accommodate the curvature of the tubularbody organ tubing to which the graft is connected.

FIG. 14 is a sectional view taken along the line 14--14 in FIG. 13.

FIG. 15 is an end sectional view of still another illustrative connectorarrangement in accordance with the present invention in which theconnector wires are curved to accommodate the curvature of the tubularbody organ tubing to which the graft is connected.

FIG. 16 is a sectional view taken along the line 16--16 in FIG. 15.

FIGS. 17a and 17b are side views of illustrative annularly-shaped wireconnectors in accordance with the present invention.

FIGS. 18a and 18b are side views of illustrative steps involved ininstalling wire connector structures such as the connector structures ofFIGS. 17a and 17b.

FIGS. 19a and 19c are side and top views, respectively, of anillustrative right-angle connection between a graft and a length of bodyorgan tubing in accordance with the present invention.

FIGS. 20a and 20b are side and top views, respectively, of anillustrative non-right-angle connection between a graft and a length ofbody organ tubing in accordance with the present invention.

FIG. 21 is a perspective view of a non-right-angled end of a grafthaving illustrative connectors in accordance with the present invention.

FIG. 22 is a perspective view of the graft of FIG. 21 connected to alength of body organ tubing.

FIG. 23 is a perspective view of a length of natural body tubing towhich two illustrative ring-shaped wire connector structures have beenattached in accordance with the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

A flexible artificial graft 30 connected to body organ tubing 32 withillustrative wire connectors 34 in accordance with the present inventionis shown in FIG. 1. Graft 30 may be a structure formed from a flexiblecoating 36 covering a frame 38. The preferred materials for formingframe 38 of graft 30 are metals, although polymeric materials may alsobe used. The presently most preferred material is a braid of nitinolwire. Wire connectors 34 are preferably formed from the same type offlexible material as frame 38 (e.g., nitinol wire). Nitinol wire is heatsensitive, so connectors 34 of various shapes may be formed by bendingthe wire of a given connector into a desired shape and applying a heattreatment to set the wire in that shape.

Coating 36 is preferably an elastic biocompatible material such assilicone, which fills the apertures formed by the wires in frame 38.Other materials that may be used for coating 36 include polymericmaterials such as stretchable urethane, stretchablepolytetrafluoroethylene (PTFE), natural rubber, and the like.

If desired, coating 36 can be formed with microscopic pores to helpimprove biocompatibility. A preferred method of providing a desiredporosity is to make coating 36 from an elastic material that is mixedwith particles of a material that can be removed (e.g., by vaporization)after coating 36 has been applied to frame 38. When the particles areremoved, voids are left in coating 36 that give it porosity.

Graft 30 may be provided with additional coatings such as medicatedcoatings, hydrophilic coatings, smoothing coatings, collagen coatings,human cell seeding coatings, etc., as described in the abovementionedGoldsteen et al. U.S. patent application Ser. No. 08/745,618, filed Nov.7, 1996, which is hereby incorporated by reference herein in itsentirety. The above-described preferred porosity of coating 12 may helpgraft 10 to retain these coatings.

In the illustrative example of FIG. 1, graft 30 has been used to form aconnection between two sections of body organ tubing 32. Graft 30 may beused to connect portions of body organ tubing of any suitable shape. Asdefined herein, the term "body organ tubing" generally refers toelongated fluid-containing body organ tissues such as blood vessels andthe like and to similar but less elongated body organ tissue structuressuch as portions of the heart wall. Body organ tubing 32 may be vasculartubing or any other type of body organ tubing.

In accordance with the present invention, connector structures such aswire connectors 34 are used to attach the ends of graft 30 to body organtubing 32. The illustrative connectors 34 of FIG. 1 are relatively shortpieces of protruding wire that are welded to frame 38.

As shown in FIG. 2, portions of the wire forming connectors 34 protrudeon both sides of the body organ tubing 32 to which graft 30 is attached.In particular, connector wires 40 protrude on one side of body organtubing wall 42 (inside tubing 32) and connector wires 44 protrude on theother side of body organ tubing wall 42 (outside tubing 32). Thisarrangement holds graft 30 firmly in place at the attachment site.

Graft 30 is depicted as a bare metal mesh in FIG. 2 and many of theother FIGS. to show the details of construction of the connectorstructures. However, graft 30 preferably has a coating such as coating36 of FIG. 1.

As shown in FIG. 2, wires 40 and 44 in each connector structure 34 arepreferably the bent ends of a single piece of wire. If desired, however,connector wires 40 and 44 may be formed from individual wire segments.

Wires 40 and 44 may be approximately 0.1-0.125 inches in length and maybe axially spaced to form a gap approximately 0.1 inches wide. Forexample, wire 40 may be approximately 0.1 inches in length and wire 44may be approximately 0.125 inches in length. Connectors 34 may be formedfrom 0.005-0.010 inch diameter round nitinol wire. These dimensions aremerely illustrative. Wire of any suitable length and diameter may beused. If desired, the wire in connectors 34 may be coated with apolymeric coating such as polytetrafluoroethylene (PTFE), to reduceabrasion of body organ tubing 32.

As shown in FIG. 3, connectors 34 are formed around the entire peripheryof end 46 of graft 30. The number of connectors 34 that are used dependson the type of graft connection being formed, the difficulty and expenseof providing additional connectors 34, and the particular type ofconnectors 34 that are used. Although connectors 34 are shown at the endof a portion of a graft 30 in FIGS. 1-3, connectors 34 may be placed atan intermediate location along the length of graft 30 if desired. Whenconnectors 34 are used to attach graft 30 to body organ tubing, aportion of the body organ tubing is engaged in gap 33 by connectors 34.

Connectors 34 may be attached to graft 30 using any suitable mountingtechnique. For example, each connector structure 34 may he interwovenwith the pattern of mesh 38 and welded at pic points or wireintersections 48, as shown in FIG. 4a. In the illustrative interweavingpattern shown in FIG. 4a, the wire of connector 34 is first placed underthe wires at a wire intersection 48 of frame 38, then over an adjacentwire intersection 48, than under the next adjacent wire intersection 48,then over the next adjacent wire intersection 48.

Another illustrative interweaving pattern and mounting technique isshown in FIG. 4b. In FIG. 4b, each connector 34 is glued to frame 38 ata wire intersection 48. The wire of connector 34 is first placed under awire intersection 48, then under an adjacent wire intersection 48, thenover the next adjacent wire intersection 48, then over the next wireintersection 48. Any suitable number of interweaving points andattachment points may be used. The number of times the wire of connector34 is interwoven with the wire of frame 38 is partly determined by thepic count of frame 38 (i.e., the number of wire intersection points inthe mesh of frame 38 per unit length along a straight axial line). Thewire of each connector 34 is attached to frame 38 sufficiently often toensure that connectors 34 are firmly attached to graft 30. Only a fewinterweaving and attachment points are shown in FIGS. 4a and 4b to avoidover-complicating the drawings.

As shown in FIG. 5, connectors 34 may be attached (e.g., welded, glued,or otherwise suitably fastened) at attachment points 50 that do notcoincide with wire intersections 48.

FIG. 5 also shows how the ends of wires 40 and 44 of each connector 34may have hooks 52 that permit connectors 34 to grip body organ tubing 32(FIG. 1). By gripping body organ tubing 32, hooks 52 facilitate theformation of a farm connection between graft 30 and body organ tubing32.

Hooks 52 may be formed by bending the ends of connectors 34, byattaching separate hook members or by any other suitable technique. Ahook 52a formed by bending the end of a connector 34 is shown in FIG.6a. A hook 52b formed by attaching a length of wire to the end of aconnector 34 is shown in FIG. 6b. FIG. 6c shows a hook 52c formed byattaching a triangular point to the end of a connector 34. Any portionof a connector that should penetrate body tissue may be barbed as shown,for example, at 52d in FIG. 6d so that the connector resists removalfrom tissue that it has penetrated.

In order to reduce tissue abrasion due to the wires of connectors 34rubbing against body organ tubing 32 (FIG. 1), at least the ends of thewires 40 and 44 of connectors 34 can be flattened rather than beingperfectly round, as shown in FIG. 7a. If initially round, wires 40 and44 (shown as wire 40/44 in FIG. 7a) may be flattened at their ends usingany suitable technique.

As shown in FIG. 7b, flattened wire 40/44 of connector 34 may beprovided with a hook 52d by bending the tip of wire 40/44.

As shown in FIG. 8, wires 40 and 44 of connectors 34 may be providedwith webs of elastic material (e.g., silicone), such as webs 54 and 56.Webs 54 and 56 help to shield body organ tubing 32 (FIG. 1) from thepotentially abrasive effects of contact with wires 40 and 44 and help tohold graft 30 to the body organ tubing 32 engaged in gap 33.

If desired, connectors 34 may be formed from wire loops, such as wireloops 58 and 60 shown in FIG. 9. Wire loops 58 and 60 may be formed bybending over extended integrally-formed portions of the wire mesh ofgraft 30, as illustrated by loop 58a. Alternatively, wire loops 58 and60 may be formed by attaching wire segments to frame 38 (e.g., bywelding, gluing, or other suitable attachment technique) at attachmentpoints 62. If frame 38 is formed from a braided wire having, e.g., 64strands, particularly suitable configurations for the connectorstructures of graft 30 may have 32, 16, 8, or 4 loops 58 and 60. Whengraft 30 of FIG. 9 is connected to body organ tubing, a portion of bodyorgan tubing is engaged in gap 33.

One suitable technique for installing a graft 30 with connectors 34 isshown in FIGS. 10a, 10b, and 10c. Prior to installation, graft 30 isloaded into sheath 68, thereby radially compressing wires 40 and 44, asshown in FIG. 10a. If desired, graft 30 may be delivered to aninstallation site in a patient intraluminally. At the installation site,graft 30 is inserted into a hole 64 that has been formed in body organtubing wall 66, as shown in FIG. 10a. During insertion, sheath 68 holdswires 40 and 44 of connectors 34 radially inward and out of the way, sothat graft 30 may be advanced through hole 64 in direction 70.

As shown in FIG. 10b, once the distal end of graft 30 is advancedthrough ho e 64 in body organ tubing wall 66, sheath 68 can be drawnbackward in direction 72. Drawing sheath 68 backward releases wires 40,which assume their normal configuration by radially expanding as shownby arrows 74.

As shown in FIG. 10c, sheath 68 is then drawn further backward indirection 72, until wires 44 are released. Wires 44 then assume theirnormal configuration by radially expanding as shown by arrows 76. Oncewires 40 and 44 have assumed their expanded configurations, graft 30 isheld in place. Sheath 68 can therefore be removed.

If the other end of graft 30 has connectors 34, the same attachmentprocess may be performed at that end of graft 30 by inserting thepreloaded sheath 68 through another hole in the body organ tubing andremoving sheath 68 through that hole (rather than moving sheath 68 awayfrom that hole as shown in FIGS. 10a-10c).

Another aspect of the invention is shown in FIGS. 11 and 12. As shown inFIG. 11, graft 30a may be provided with connectors 34a having curvedwires 40a and 44a. Wires 40a and 44a are curved to varying degrees tomatch the curvatures encountered in making a graft connection with atubular portion of body organ tubing 32a. The end view of FIG. 11 showshow wires 40a and 44b of the connectors 34a that run along the curvedportion of tubular body organ tubing 32a are highly curved. The sideview of FIG. 12 shows how wires 40a and 44b of the connectors 34a thatrun along the interior and exterior surfaces of tubular body organtubing 32a parallel to the longitudinal axis of tubular body organtubing 32a are not curved. Other connectors 34a that lie in planes notshown in FIGS. 11 and 12 preferably have wires 40a and 44a that are lesscurved than the wires 40a and 44a of FIG. 11 and that are more curvedthan the wires 40a and 44a of FIG. 12. Body organ tubing 32a is engagedin the gap 33a between wires 40a and 44a.

As shown in FIGS. 13 and 14, graft 30b may use connectors 34b with wires40b that extend sufficiently into the interior of tubular body organtubing 32b that wires like wires 44a of FIG. 11 are not required on theexterior surface of body organ tubing 32b. In particular, because wires40b run down along the interior surface of tubular body organ tubing 32past bisecting plane 78, a single set of wires 40b can hold graft 30b inplace. The end view of FIG. 13 shows how wires 40b that run along thecurved portion of tubular body organ tubing 32b are highly curved. Theside view of FIG. 14 shows how wires 40b of the connectors 34b that runalong the interior surface of tubular body organ tubing 32b in the axialdirection are not curved. Other connectors 34b that lie in planes notshown in FIGS. 13 and 14 may have wires 40b that are less curved thanthe wires 40b of FIG. 13 and that are more curved than the wires 40b ofFIG. 14 if desired.

Another connector arrangement is shown in FIGS. 15 and 16. As shown inFIG. 15, graft 30c may use connectors 34c having some wires 40c thatextend completely around the interior of tubular body organ tubing 32c,so that wires such as wires 44a of FIG. 11 are not required on theexterior surface of body organ tubing 32c. In particular, wires 40c inthe plane of the end view of FIG. 15 run completely around the interiorsurface of tubular body organ tubing 32c, so that a single set of wires40c holds graft 30c in place. The side view of FIG. 16 shows how wires40c of the connectors 34c that run along the interior surface of tubularbody organ tubing 32c parallel to the longitudinal axis of tubular bodyorgan tubing 32c are not curved. Other connectors 34c that lie in planesnot shown in FIGS. 15 and 16 may be less curved than the connectors 34cof FIG. 15 and more curved than the connectors 34c of FIG. 16.

The connectors 34a, 34b, and 34c of FIGS. 11-16 may be installed usingthe installation procedure shown in FIGS. 10a, 10b, and 10c.

Another type of wire connector structure that may be used is shown inFIG. 17a. The wires 79 of wire connector 80 are preferably integrallyformed from a portion of frame 38 of graft 30. Wire connector 80 has anupper annular portion 82 and a lower annular portion 84. Portions 82 and84 perform the connecting functions of wires 40 and 44 of connectorssuch as connectors 34 of FIG. 2. Graft 30 is connected to body organtubing by engaging a portion of body organ tubing in gap 33 betweenportions 82 and 84.

One suitable approach for fabricating connector structures such as wireconnector 80 is to form frame 38 over a mandrel and then to heat treatframe 38 in a furnace. This technique causes heat sensitive metals suchas nitinol to retain the shape of the mandrel after the heat treatmenthas been completed and the frame 38 has been removed from the mandrel.Similar deformation and heat treatment steps can be used to formconnectors 34 of FIGS. 1-16.

If desired, reinforcing wires 86 may be provided to line the innersurface of connector structure 80 as shown in FIG. 17b. Reinforcingwires 86 may be attached to frame 38 by any suitable attachmenttechnique, such as by welding or gluing.

One suitable technique for installing a graft 30 with a connector 80 isshown in FIGS. 18a and 18b. As shown in FIG. 18a, graft 30 is insertedinto a hole 88 in body organ tubing wall 90 using sheath 92. Beforeinsertion, graft 30 is preloaded into sheath 92, thereby holdingportions 82 and 84 of connector 80 radially inward and out of the way,so that graft 30 may be inserted through hole 88. To insert graft 30 inhole 88 of body organ tubing wall 90, sheath 92 and graft 30 areadvanced in direction 94.

As shown in FIG. 18b, once the distal end of graft 30 is advancedthrough hole 88 in body organ tubing wall 90, sheath 92 can be drawnbackward in direction 96. Drawing sheath 92 backward releases portions82 and 84 of wire connector 80, so that connector 80 assumes its normalradially-expanded configuration and holds graft 30 in place. Sheath 92can therefore be removed.

If the other end of graft 30 has a connector 80, the same attachmentprocess may be performed at that end of graft 30 by inserting thepreloaded sheath 92 through a hole in the body organ tubing near thatend and removing sheath 92 through that hole (rather than moving sheath92 away from the hole as shown in FIG. 18a).

It is sometimes desirable to make connections between a graft and aportion of body organ tubing at a non-right angle, sometimes referred toherein as an oblique angle. The wire and frame-based connectors of thepresent invention are suitable for forming such connections.

A typical right-angle connection between a graft 30 and a portion ofbody organ tubing 32 is shown in FIG. 19a. As shown in FIG. 19b, such aright-angle connection creates a circular hole 98 in body organ tubing32.

An oblique-angle connection between graft 30 and a portion of body organtubing 32 is shown in FIG. 20a. Making an oblique-angle connectiontypically forms a hole 100 in body organ tubing 32 that has a largerperimeter than the circular hole 98 of FIG. 19b. The large perimeter ofhole 100 provides a larger contact area over which to form a firmconnection between graft 30 and body organ tubing 32. In addition,during some installation procedures it may not be convenient orpractical to use a right-angle arrangement.

Any of connectors 32 or 80 may be used to form an oblique-angleconnection between a graft 30 and a portion of body organ tubing 32.FIG. 21 shows how the obliquely-angled distal tip 102 of graft 30 mayhave connectors 34 formed from wires 40 and 44 around its periphery.When installed, wires 44 grip the outer surface of body organ tubing 32,as shown in FIG. 22. Wires 40 (not shown in FIG. 22) grip thecorresponding inner surface of the body organ tubing 32 of FIG. 22.

The oblique-angle connection between graft 30 and body organ tubing 32of FIG. 22 uses connectors 34 formed from wires 40 and 44. If desired,similar oblique-angle connections may be formed using the webbedconnector arrangement of FIG. 8, the looped connector arrangement ofFIG. 9, the curved connector wire arrangements of FIGS. 11-16, or theintegral frame connector arrangement of FIGS. 17a and 17b. When used foroblique-angle graft attachment procedures, sheaths such as sheath 68 ofFIG. 10 and sheath 92 of FIG. 18 preferably have obliquely-angled ends.

Wire connectors 32 and 80 may be provided as stand-alone connectors ifdesired. For example, connectors such as connectors 34 of FIG. 2 may beattached to suitable ring structures 104, as shown in FIG. 23. Ringstructures 104, which are preferably formed from a suitable elastomericmaterial, may be attached to a length of natural graft 106 by sutures108. The resulting natural graft with artificial connectors may be usedwhenever a natural graft is appropriate but the ease of installationprovided by connectors 34 is desired. Similar ring-like stand-alonestructures may be provided using the webbed connector arrangement ofFIG. 8, the looped connector arrangement of FIG. 9, the curved connectorwire arrangements of FIGS. 11-16, or the integral frame connectorarrangement of FIGS. 17a and 17b.

It will be understood that the foregoing is only illustrative of theprinciples of the invention, and that various modifications can be madeby those skilled in the art without departing from the scope and spiritof the invention.

The invention claimed is:
 1. An artificial graft for attachment to thebody organ tubing of a patient comprising:an elongated flexible tubulargraft structure; and a first plurality of wires that are disposed aroundthe periphery of one end of the elongated flexible tubular graftstructure and a second plurality of wires that are disposed around theperiphery of the elongated flexible tubular graft structure at anaxially spaced position relative the first plurality of wires to definea gap in which a portion of the body organ tubing is engaged between thefirst and second pluralities of wires, wherein:at least some of thewires in the first and second pluralities of wires comprise wireloops;the attached wire loops are attached to the elongated flexibletubular graft structure; and the wire loops are welded to the elongatedflexible tubular graft structure.
 2. An artificial graft for attachmentto the body organ tubing of a patient comprising:an elongated flexibletubular graft structure; a first plurality of wires that are disposedaround the periphery of one end of the elongated flexible tubular graftstructure and a second plurality of wires that are disposed around theperiphery of the elongated flexible tubular graft structure at anaxially spaced position relative the first plurality of wires to definea gap in which a portion of the body organ tubing is engaged between thefirst and second pluralities of wires; and hooks on at least some of thewires in the first and second pluralities of wires for engaging the bodyorgan tubing; wherein the hooks comprise separate attached hook members.3. An artificial graft for attachment to the body organ tubing of apatient comprising:an elongated flexible tubular graft structure; afirst plurality of wires that are disposed around the periphery of oneend of the elongated flexible tubular graft structure and a secondplurality of wires that are disposed around the periphery of theelongated flexible tubular graft structure at an axially spaced positionrelative the first plurality of wires to define a gap in which a portionof the body organ tubing is engaged between the first and secondpluralities of wires; and hooks on at least some of the wires in thefirst and second pluralities of wires for engaging the body organtubing; wherein the hooks have barbs.
 4. An artificial graft forattachment to the body organ tubing of a patient comprising:an elongatedflexible tubular graft structure; and a first plurality of wires thatare disposed around the periphery of one end of the elongated flexibletubular graft structure and a second plurality of wires that aredisposed around the periphery of the elongated flexible tubular graftstructure at an axially spaced position relative the first plurality ofwires to define a gap in which a portion of the body organ tubing isengaged between the first and second pluralities of wires; wherein atleast some of the wires in the first and second pluralities of wires arewelded to the elongated flexible tubular graft structure.
 5. Anartificial graft for attachment to the body organ tubing of a patientcomprising:an elongated flexible tubular graft structure; and a firstplurality of wires that are disposed around the periphery of one end ofthe elongated flexible tubular graft structure and a second plurality ofwires that are disposed around the periphery of the elongated flexibletubular graft structure at an axially spaced position relative the firstplurality of wires to define a gap in which a portion of the body organtubing is engaged between the first and second pluralities of wires;wherein at least some of the wires in the first and second pluralitiesof wires are glued to the elongated flexible tubular graft structure. 6.An artificial graft for attachment to the body organ tubing of a patientcomprising:an elongated flexible tubular graft structure; and a firstplurality of wires that are disposed around the periphery of one end ofthe elongated flexible tubular graft structure and a second plurality ofwires that are disposed around the periphery of the elongated flexibletubular graft structure at an axially spaced position relative the firstplurality of wires to define a gap in which a portion of the body organtubing is engaged between the first and second pluralities of wires,wherein:the elongated flexible tubular graft structure comprises a wiremesh frame; and at least some of the wires in the first and secondpluralities of wires are interwoven with the wire mesh frame.
 7. Anartificial graft for attachment to the body organ tubing of a patientcomprising:an elongated flexible tubular graft structure; and a firstplurality of wires that are disposed around the periphery of one end ofthe elongated flexible tubular graft structure and a second plurality ofwires that are disposed around the periphery of the elongated flexibletubular graft structure at an axially spaced position relative the firstplurality of wires to define a gap in which a portion of the body organtubing is engaged between the first and second pluralities of wires,wherein:each wire in the first plurality of wires is associated with oneof the wires in the second plurality of wires; each wire in the firstplurality of wires is formed from the same piece of wire as itsassociated wire in the second plurality of wires; the elongated flexibletubular graft structure comprises a wire mesh frame having mesh wiresthat intersect at wire intersection points; at least some of the wiresin the first and second pluralities of wires are interwoven with thewire mesh frame; and at least some of the wires in the first and secondpluralities of wires are welded to the elongated flexible tubular graftstructure at the wire intersection points.
 8. An artificial graft forattachment to the body organ tubing of a patient comprising:an elongatedflexible tubular graft structure; a first plurality of wires that aredisposed around the periphery of one end of the elongated flexibletubular graft structure and a second plurality of wires that aredisposed around the periphery of the elongated flexible tubular graftstructure at an axially spaced position relative the first plurality ofwires to define a gap in which a portion of the body organ tubing isengaged between the first and second pluralities of wires; and anelastic web covering at least some of the wires in the first and secondpluralities of wires.
 9. An artificial graft for attachment to the bodyorgan tubing of a patient comprising:an elongated flexible tubular graftstructure; and a first plurality of wires that are disposed around theperiphery of one end of the elongated flexible tubular graft structureand a second plurality of wires that are disposed around the peripheryof the elongated flexible tubular graft structure at an axially spacedposition relative the first plurality of wires to define a gap in whicha portion of the body organ tubing is engaged between the first andsecond pluralities of wires; wherein the portion of body organ tubing towhich the artificial graft is attached has a hole, the artificial graftstructure further comprising a tubular sheath that holds the first andsecond pluralities of wires in a radially compressed position duringinsertion of the artificial graft and the tubular sheath into the holeand that releases the first and second pluralities of wires duringremoval of the tubular sheath while the artificial graft is maintainedwithin the hole so that the first and second pluralities of wiresradially expand to engage the portion of body organ tubing.
 10. Anartificial graft for attachment to the body organ tubing of a patientcomprising:an elongated flexible tubular graft structure; and a firstplurality of wires that are disposed around the periphery of one end ofthe elongated flexible tubular graft structure and a second plurality ofwires that are disposed around the periphery of the elongated flexibletubular graft structure at an axially spaced position relative the firstplurality of wires to define a gap in which a portion of the body organtubing is engaged between the first and second pluralities of wires;wherein the elongated flexible tubular graft structure has anobliquely-angled end.
 11. An artificial graft for attachment to aportion of the body organ tubing of a patient, wherein the portion ofbody organ tubing s tubular in shape and wherein a plane bisecting thetubular body organ tubing lies along the longitudinal axis of thetubular body organ tubing, the artificial graft comprising:an elongatedflexible tubular graft structure; and a plurality of wires disposedaround the periphery of one end of the elongated flexible tubular graftstructure, wherein at least some of the wires extend away from the endof the elongated flexible tubular graft structure and along the innersurface of the tubular body organ tubing past the bisecting plane. 12.The artificial graft of claim 11, wherein at least some of the wiresthat extend along the inner surface of the tubular body organ tubingextend entirely around the inner surface of the tubular body organtubing.
 13. An artificial graft for attachment to the body organ tubingof a patient comprising:an elongated flexible tubular graft structure;and a first plurality of radially extending wires that are disposedaround the periphery of one end of the elongated flexible tubular graftstructure and a second plurality of radially extending wires that aredisposed around the periphery of the elongated flexible tubular graftstructure at an axially spaced position relative the first plurality ofwires to define a gap which engages a portion of the body organ tubingwithout piercing the body organ tubing with the wires, wherein at leastsome of the wires in the first and second pluralities of wires arewelded to the elongated flexible tubular graft structure.
 14. Anartificial graft for attachment to the body organ tubing of a patientcomprising:an elongated flexible tubular graft structure; and a firstplurality of radially extending wires that are disposed around theperiphery of one end of the elongated flexible tubular graft structureand a second plurality of radially extending wires that are disposedaround the periphery of the elongated flexible tubular graft structureat an axially spaced position relative the first plurality of wires todefine a gap which engages a portion of the body organ tubing withoutpiercing the body organ tubing with the wires, wherein at least some ofthe wires in the first and second pluralities of wires are glued to theelongated flexible tubular graft structure.
 15. An artificial graft forattachment to the body organ tubing of a patient comprising:an elongatedflexible tubular graft structure; and a first plurality of radiallyextending wires that are disposed around the periphery of one end of theelongated flexible tubular graft structure and a second plurality ofradially extending wires that are disposed around the periphery of theelongated flexible tubular graft structure at an axially spaced positionrelative the first plurality of wires to define a gap which engages aportion of the body organ tubing without piercing the body organ tubingwith the wires, wherein:the elongated flexible tubular graft structurecomprises a wire mesh frame; and at least some of the wires in the firstand second pluralities of wires are interwoven with the wire mesh frame.16. An artificial graft for attachment to the body organ tubing of apatient comprising:an elongated flexible tubular graft structure; and afirst plurality of radially extending wires that are disposed around theperiphery of one end of the elongated flexible tubular graft structureand a second plurality of radially extending wires that are disposedaround the periphery of the elongated flexible tubular graft structureat an axially spaced position relative the first plurality of wires todefine a gap which engages a portion of the body organ tubing withoutpiercing the body organ tubing with the wires, wherein:each wire in thefirst plurality of wires is associated with one of the wires in thesecond plurality of wires; each wire in the first plurality of wires isformed from the same piece of wire as its associated wire in the secondplurality of wires; the elongated flexible tubular graft structurecomprises a wire mesh frame having mesh wires that intersect at wireintersection points; at least some of the wires in the first and secondpluralities of wires are interwoven with the wire mesh frame; and atleast some of the wires in the first and second pluralities of wires arewelded to the elongated flexible tubular graft structure at the wireintersection points.
 17. An artificial graft for attachment to the bodyorgan tubing of a patient comprising:an elongated flexible tubular graftstructure; and a first plurality of radially extending wires that aredisposed around the periphery of one end of the elongated flexibletubular graft structure and a second plurality of radially extendingwires that are disposed around the periphery of the elongated flexibletubular graft structure at an axially spaced position relative the firstplurality of wires to define a gap which engages a portion of the bodyorgan tubing without piercing the body organ tubing with the wires,wherein the portion of body organ tubing to which the artificial graftis attached has a hole, the artificial graft structure furthercomprising a tubular sheath that holds the first and second pluralitiesof wires in a radially compressed position during insertion of theartificial graft and the tubular sheath into the hole and that releasesthe first and second pluralities of wires during removal of the tubularsheath while the artificial graft is maintained within the hole so thatthe first and second pluralities of wires radially expand to engage theportion of body organ tubing.
 18. An artificial graft for attachment tothe body organ tubing of a patient comprising:an elongated flexibletubular graft structure; and a first plurality of radially extendingwires that are disposed around the periphery of one end of the elongatedflexible tubular graft structure and a second plurality of radiallyextending wires that are disposed around the periphery of the elongatedflexible tubular graft structure at an axially spaced position relativethe first plurality of wires to define a gap which engages a portion ofthe body organ tubing without piercing the body organ tubing with thewires, wherein the elongated flexible tubular graft structure has anobliquely-angled end.